Encouraging Entrustment: A Qualitative Study of Resident Behaviors That Promote Entrustment

Area of Science:

• Medical Education
• Physician Training
• Trust and Entrustment

Background:

• Supervisor entrustment is crucial for resident autonomy.
• Understanding resident behaviors that foster trust is essential for effective medical training.

Purpose of the Study:

• To explore resident and attending physician perceptions of behaviors demonstrating trustworthiness.
• To identify factors promoting supervisor entrustment of trainees.

Main Methods:

• Grounded theory methodology utilized 6 focus groups (3 with residents, 3 with attending physicians).
• Data collected and analyzed iteratively until theoretical saturation was achieved.
• Three independent reviewers coded transcripts; codes were grouped into themes to develop a conceptual model.

Main Results:

• Twelve residents and 18 attending physicians participated.
• Participants identified actions demonstrating trustworthiness.
• Four modifiers emerged: self-management, relationships, self-advocacy, and patient-centeredness.

Conclusions:

• Trainees must actively demonstrate trustworthiness to gain supervisor entrustment.
• Self-management, relationships, self-advocacy, and patient-centeredness enhance trainee entrustment.
• A novel framework is proposed to help trainees foster autonomy and progress toward independent practice.